不同入路胸腔镜手术治疗前纵隔肿瘤的临床疗效比较  

Comparison of Clinical Efficacy of Thoracoscopic Surgery with Different Approaches in the Treatment of Anterior Mediastinal Tumors

作　　者：李晓亮[1] 刘高华 刘蔡杨 姚益 李季[1] Li Xiaoliang;Liu Gaohua;Liu Caiyang;Yao Yi;Li Ji(Department of Cardiothoracic Surgery,Neijiang First People's Hospital,Neijiang 641000,China)

机构地区：[1]内江市第一人民医院胸心外科,内江641000

出　　处：《成都医学院学报》2021年第6期743-746,共4页Journal of Chengdu Medical College

摘　　要：目的比较不同入路胸腔镜手术治疗前纵隔肿瘤(AMT)的临床效果。方法将2016年1月至2020年12月内江市第一人民医院收治的AMT患者126例作为研究对象,按照手术方法分为A组(n=40)、B组(n=48)及C组(n=38),A组行经肋间入路,B组行经剑突下三孔入路,C组行经剑突下单孔入路。观察3组术中出血量、手术时间、引流管留置时间、术后引流量及术后住院时间等指标,术后24、48、72 h疼痛评分以及术后并发症。结果 B、C组术中出血量、手术时间、引流管留置时间、术后引流量、术后住院时间及术后24、48、72 h疼痛评分和术后并发症发生率均小于A组(P<0.05);与B组相比,C组术后24、48、72 h疼痛评分小于B组(P<0.05),其余指标比较差异无统计学意义(P>0.05)。结论与经肋间入路相比,经剑突下入路手术治疗前纵隔肿瘤具有明显优势,其中剑突下单孔入路创伤小,术后疼痛轻,恢复快。Objective To compare the clinical efficacy of thoracoscopic surgery with different approaches in the treatment of anterior mediastinal tumors(AMT).Methods A total of 126 patients with AMT admitted to Neijiang First People’s Hospital from January 2016 to December 2020 were retrospectively divided into group A(n=40), group B(n=48) and group C(n=38). Group A received thoracoscopic resection via intercostal approach, group B via subxiphoid three-foramen approach, and group C via subxiphoid single-foramen approach. Intraoperative blood loss, duration of operation, duration of indwelling of drainage tube, postoperative drainage volume, postoperative hospital stay, postoperative pain scores at 24, 48 and 72 h, and postoperative complications were observed in the three groups.Results Intraoperative blood loss, duration of operation, duration of indwelling of drainage tube, postoperative drainage volume, postoperative hospital stay, postoperative pain scores at 24, 48 and 72 h, and incidence of postoperative complications in group B and C were all lower than those in group A(P<0.05). Postoperative pain scores at 24, 48 and 72 h in group C were lower than those in group B(P<0.05). There was no statistical significance in other indicators(P>0.05).Conclusion Compared with the intercostal approach, the subxiphoid approach has obvious advantages in various indicators in the treatment of AMT, especially the subxiphoid single-foramen approach, which has the advantages of less trauma, less postoperative pain and faster recovery.

关 键 词：不同入路 胸腔镜切除术 前纵隔肿瘤 临床疗效 

分 类 号：R655.5[医药卫生—外科学]